Monday, April 29, 2013

In a desperate attempt to understand and hopefully manage my increasingly debilitating knee pain during and after bicycling, this weekend I sought the assistance of Dr. Greg Combs at Velosmart. During the three-hour evaluation, he took some measurements, ran a motion analysis of my pedal stroke aboard my current mountain bike situated on a stationary trainer, and devised a rehabilitation plan for me. Reviewing the video motion capture was quite an interesting experience, as was seeing the results of his measurements.

It appears that while my so-called "leg length discrepancy" is minimal, there is a significant difference with regard to the left/right and fore/aft sections of my pelvic alignment. In other words, I am apparently twisting the core part of my body substantially, particularly when on the bike, which is putting extensive unnecessary stress on not only my knees, but also my hips, ankles, feet, back and abdominal core - yikes.

My initial video analysis showed a fairly significant discrepancy between the right and left legs and feet during the pedal stroke, along with a definitive shift in hip motion. And while riding with only one hand on the handlebar, I was also unable to balance myself without leaning disproportionately to one side or the other when pedaling - even on my own bike on the stationary trainer!

To help resolve these problems, Dr. Combs demonstrated a couple of pre-biking stretches to help realign my pelvis and legs to a more even and normal position. During Steve's observation of these stretches - they are partner assisted so he watched closely to learn his role and had a better view of the shifts in body alignment changes before and after - he noted that the improvement after just four repetitions was "astonishing". The stretches consisted of adducting (moving toward the centerline of the body) bent knees against pressure and then abducting (moving away from the centerline of the body) bent knees against pressure. I have to admit I was quite surprised at the magnitude of change generated in my hip/knee/ankle/pelvic alignment with just four repetitions of such simple stretches.

Additionally, the worn-out orthotics in my bike shoes were replaced with some that provided increased support and alignment assistance. My saddle position was tweaked and surprisingly to me, it was suggested to move my cleats a bit BEHIND the traditional ball of the foot position. Then it was back on my bike for a second video analysis. This time my left/right leg pedal strokes were vastly improved and much closer to ideal, and I was able to balance much better riding one-handed. Additionally, with the new - and in my opinion, improved - cleat position, I also noticed no more toe numbness/tingling, and my feet felt more solidly supported on the pedals.

A couple more tiny adjustments, and it was on the bike again for the third video analysis. This time, the alignment was improved even more, and I felt completely balanced riding one-handed. So Dr. Combs elected to leave the adjustments at this level and had me dismount the bike. Then he brought out two scary looking pieces of rubber tubing. Placing one around both legs above the knees and one around both legs at the ankles, he instructed me in several resistance exercises which he said would clearly delineate areas of weakness where the muscles were firing insufficiently or not at all. In my case, that apparently was predominately the gluteus medius (the muscle just at the top of the hip joint), as there was intense burning in that location after one - yes just ONE - set of 10 reps of the three exercises on each leg. And that was using the "beginner" lightweight straps! He prescribed doing those exercises several times a day until I was strong enough to move to the "intermediate" heavier straps and then eventually to the "advanced" heaviest straps (can you say "OUCH"?). He also prescribed doing four sets of the adduction/abduction stretching exercises before each bike ride. Finally, he suggested that I work on getting comfortable mounting and dismounting the bike from either side instead of just the left like I always have, in order to facilitate even muscular strength and development (not to mention it's just a good idea to be able to get on and off the bike from either side since you never know what trail terrain is going to be!...).

Naturally, it started raining while I was at the human performance lab and the rain has continued to the current time with even more forecast for the next few days, so I haven't yet been able to do a test ride to see what, if any, difference these changes make. But as soon as the weather breaks and the trails are sufficiently dry to ride, I'm looking forward to seeing how I feel on the bike. On the upside, all this rain is at least giving me time to get started solidly on the new exercise routine so maybe by the time I head out to the trails, my pelvis will be on its way toward realignment and my glutes will have strengthened up enough to provide some much needed support for my knees and the rest of my bicycling "engine".

Tuesday, April 16, 2013

Maybe I jumped in too fast, too soon, with my return to mountain biking. Maybe I love food too much and carrying those additional pounds is too much of a strain . Or maybe my aging joints just can't handle repetitive motion any more.

Regardless of the cause, I'm finding that the more I bike, the more pain and weakness I'm experiencing once again in my post surgical right knee. Lately I'm finding that sometimes as quickly as the first couple of miles on a trail, I begin to experience a deep tender ache just below the front of the kneecap which wraps around the entire outside of the knee. With continued pedaling, and particularly the exertion of climbing or standing, the pain progresses to a searing sharp pain with associated give-way weakness.

I'm married to a bike geek/mechanic and in an effort to mitigate the knee pain and weakness we've tried adjusting my bike (the frame itself seems to fit me perfectly) with all varieties of stems, saddles, pedals, cleats, seatposts, through the whole range of positioning of said items, to no real avail yet.
I had my previous bikes fitted years ago when I was being coached and
that seemed to work okay, but that was prior to having my knee surgery. Following a right lateral
retinacular release, I ended up basically taking a few years away from regular biking and racing. In the intervening several years, I got fat, got old, got weak and got disgusted enough with my lack of activity and ambition that I decided I wanted to come back to the sport that meant so much to me for so many years, so I started mountain biking again.

With my recent return to riding - probably too much too soon, which is likely a big part of my current issues - I'm now finding that the
pain and weakness have also returned with a vengeance. It's gotten to the point where it's once again quite painful to put any real resistance to the bike pedals, climb and especially descend stairs, or sit for prolonged periods, and the
knee gives way often with biking and sometimes even with routine
activities like kneeling or sitting/rising to stand. I've been told
(by an orthopedist who bikes) that I most likely have an ugly combination
of patellofemoral syndrome, iliotibial band syndrome, degenerative
joint disease, osteoarthritis and a chip in the kneecap bone. To make matters worse, I also have a slight leg length discrepancy, with the post surgical leg being a tad longer than the other, which makes adjusting seat height a nightmare. Lastly, I'm now in my 50s and have gained a lot of weight over the past few years
which is not helping matters at all. I've been trying all manner of stretches, exercises and anti-inflammatories to try to strengthen and loosen things up in my lower extremities but so far, the pain and weakness are tenaciously resistant to any and all attempts at mitigation.

I'm wondering now if I might need to have a
professional bike fit done just to make sure I have things generally set up as well as they possibly can be to accommodate all these concerns. Unfortunately, I suspect that the fact of the matter is
it's likely I am probably not ever going to be able to ride pain-free
due to all the joint and bone problems. However, it would be nice to
at least be able to get through more than a small handful of miles on a flat easy course
before being in so much agony that I have to hobble back to the trailhead, dragging my bike behind me...

So with that in mind, I'm checking the local bike scene to see if I can locate a superior bike fitter with knowledge and experience in knee issues. Wish me luck - I have a gut feeling I'm gonna need it.

Sunday, April 14, 2013

After my fiasco of an attempt at a race last weekend at Warrior Creek, Mother Nature apparently decided to give me a reprieve and a chance to redeem myself by raining out the local Curse at the Crab 6 hour race originally slated for the same day and causing it to be postponed until THIS weekend.

My female duo partner had decided to take a break from racing for a few weeks, so my dear husband Steve agreed to partner up with me and we entered as a coed duo for this one. Curse at the Crab is traditionally a fun, low key local endurance event, so Fry joined us this time around as well. Before the race, we took him down to the lake for a quick swim and then spread out his blanket in a nicely shaded pit area, set out his water bowl and gave him his cookie, bully stick and chew toy. Debbie stopped by our pit area to get a photo, but Fry was more interested in watching all the pre-race bustle of activity than posing for the camera!

With the experience gained by attending a few downhill races last year, Fry has become quite comfortable settling into the routine and was fairly content to observe all the goings-on, even if he did find it a little disappointing that he couldn't join Mommy and Daddy on the bike trail this time.

Steve rode the first lap for us, while Fry and I hung out with Juan to snap a picture or two.

Lake Crabtree is a fast trail without too much in the way of technical, and is just plain fun to ride. Coupled with the gorgeous weather and the friendly faces on the course, it was impossible not to have a good time. I don't know if I just got lucky with my positioning in the laps or if this trail is that well designed for traffic, but every single person I overtook or who overtook me seemed to have good race experience and each pass was managed seamlessly with no loss of momentum for either rider.

Despite having increasingly severe pain in my right (post surgical) knee, I managed to keep my lap times fairly close to Steve's. Of course, a lot of that was due to the fact that his singlespeed gearing was a little low for this particular trail. He still rocked it though, and put us into a good position after his first lap.

The race ran from mid afternoon into the night. We alternated the first three laps, then I doubled up for a fourth and Steve doubled up on his fourth and fifth since we only brought one set of lights and he enjoys night riding more than I do.

In the end, out of five coed duo teams, Steve and I wound up in third place with nine laps, while first and second got ten laps each. Especially considering neither of us had really prepared for this race and were just out there for the fun of it, we felt good about our results and the fact that our lap times remained pretty consistent throughout.

It was a great way to spend a beautiful Saturday - riding a fun trail throughout the afternoon and evening, seeing some old friends and making new ones, and sharing time with Steve and Fry, the two best guys in my life.

Sunday, April 7, 2013

Okay, so it's actually Sunday. But with our little furbaby, let's face it - pretty much EVERY day is Fryday around here.

Since Fry had limited outside time yesterday, we decided to give him a good outing today, especially since it was such gorgeous spring weather with full sun and temperatures in the low 70s.

We took the little man out for a trail run, but it turned out to be bonus fun when we happened across another couple out enjoying the day with their two dogs as well. The three pups played together great and Fry especially had a blast with the other three-year-old male, a lab/Plotthound mix (the beagle was more interested in following her nose to check out all the woodsy smells). The two boys ran around, played chase with sticks, swam in the creek, and the Plotthound even taught Fry how to take a big high JUMP into the creek. Once Fry realized how cool he looked leaping dock-jumping-dog style into the water, he was more than happy to show us all his new skill multiple times! Unfortunately, Steve and I both completely forgot he had the camera in his backpack, so no pictures this time. You'll just have to take my word for the fact that Fry is totally awesome. :-)

After about a half-hour of doggy play time, we said our goodbyes and hit the trail again to let Fry get a little more running around as he was newly refreshed from his swim. Then it was back home, where he played outside in the yard briefly and chased a few squirrels, and has now curled up on the couch, head on a comfy pillow, for a well-earned nap.

Saturday, April 6, 2013

Not even close. At the 6 Hours of Warrior Creek today, I competed in the Duo Female category. Despite the rain on Thursday, the trail was in surprisingly excellent shape for the race and just got better as the day progressed. So even though I had ever ridden WC before, we at least had good trail conditions - thanks BMCC Trail Crew!

We had already decided ahead of time to just take our time and enjoy the ride for a low pressure race - a challenge in itself at such a big event (408 registered racers) - and my teammate rolled into the transition area two hours after the start. The first words out of her mouth were "There were SO many climbs!" and she looked completely wiped out, so my stress level about this unknown-to-me course increased a few notches. She also indicated that she didn't think she wanted to ride another lap, so I headed out onto the trail, wondering if I would be able to do two back-to-back 13+ mile laps in my current extremely unfit state.

As I wound around the twisting and curving trail, it wasn't long before I realized my lifelong acrophobia with associated height vertigo was flaring more than usual and by the third (yes, only the THIRD) mile in, I was actually bordering on a panic attack, feeling like I could not balance myself at all and completely unable to manage the larger bermed turns. Consumed by the perception that I was, at any second, going to fall off the side of the mountain into a deep-ass lake far, far below (despite the reality that the trail is, in fact, plenty wide and beautifully bench cut), I was reduced to walking most of the switchbacks and what I perceived as "exposed" areas. I was feeling utterly and completely humiliated to have multitudes of other riders catch and pass me as I hiked alongside my bike on these very smooth and totally rideable stretches of trail. It was beyond embarrassing and I just wanted to crawl in a hole and die, when I heard a familiar voice ask me how I was doing. I realized it was Steve who had been sitting by the trail taking photos, and I could barely choke back the tears when I told him I was just terrified.

My dear sweet husband, realizing the trouble I was having, apparently took a few pictures during the sparse moments I was actually ON my bike, making it appear I rode a lot more than I did, but since I could not look up without increasing the dizziness, I didn't even realize he had done that. Thanks Honey - you're the Best.

For the next what seemed like a thousand miles, I stumbled and struggled along as best I could, focused purely on trying to stay out of everyone else's way as much as possible, feeling crushed, defeated and wishing I was anywhere but on this trail at this moment.

I continued to walk an excessive amount of a trail I should most certainly have been able to clean with ease. I wussed on the handful of simple rock gardens, and chickened out and walked far too many of the ledges and the big berms which I'm sure looked much worse to me than they actually were in reality, although I did force myself to ride all but two of the bridges, including the rock creek crossing. Despite this, I continued to struggle hopelessly and gave up almost immediately on most of the steep climbs and tighter switchbacks. Additionally, I was not confident enough to ride the bigger berms high like you're supposed to, and riding them low only made the turns too tight for me to manage. So between riding so slowly the bike barely remained upright and just flat-out walking many sections, I ended up spending most of my time on the trail pulling over to let the 400+ legitimate racers get around me. By my watch, I spent at least 20 minutes of my lap simply pulling off to let folks pass. I was an obstacle, a speed bump, but most certainly NOT a racer.

Fortunately, by the last mile or so of the trail, I somehow miraculously managed to clean the last series of uphill switchbacks and gradually the dizziness started to clear a bit. I was starting to feel a little more comfortable and somewhat less dizzy and slightly less terrified now, but by this time my lap was almost finished. I still was expecting to have to do another lap, but to my great surprise - and relief - Sarwat was standing in the transition area with Steve when I finally crawled in with my tail tucked between my legs after two-plus hours. To my tremendous relief, my teammate told me she felt better after a break and wanted to go ahead and ride another lap. She went out and turned a 1:43 lap but missed the cutoff thanks to my ridiculously slow run, so we ended up with only three laps, for dead last out of 15 female duos.

To answer the question, am I a warrior? Nope, not even close. Tonight I don't even feel like a mountain biker. In fact, I don't feel like much of anything except an old, out of shape, overweight, unfit embarrassment to my bike, my teammate, my dear husband and myself. Right now, the one positive I can find from today (other than at least see the incredible work the BMCC trail crew has done on these trails and attend a beautifully run event in a spectacular location) is that I got punched in the face with the reality that I can no longer just sit here and pretend like maybe I've not really totally let myself go health wise for the past several years. It's painfully obvious to me now that I have ignored my health, my weight, my fitness and my athletic skill potential, and the scary part is that at this point I'm not 100 percent convinced it isn't too late to recover from it all.

Thursday, April 4, 2013

To steal a quote from one of my favorite television shows, "Holy crap on a cracker..."

Either as a result of menopausal wackiness, a momentary lapse of sanity, or just some weird unthinking whim, when I got a wait-list email from Jason that a couple of spots had opened up for the 6 Hours of Warrior Creek, I threw caution to the wind and said "I'll take them!" This, in spite of the fact that 1) I have never in my life even seen those trails, 2) I am the most unfit I've been in many, many years, 3) I weigh more than I have in, heck, I can't even remember when, and 4) the majority of my sporadic mountain bike rides for the past year have been sub-five-mile, sub-half-hour jaunts on easy local trails and I frequently could use a nap and a sandwich just to get through those!

What on earth I was thinking to sign up for this thing I may never know, and as soon as the payment was made, the sane portion of my brain asked, no screamed, "What on earth did you just do???". Regardless, what was done was done, so I immediately began the search to find a teammate.

As I had done the 6 hour Meltdown at Harris Lake last month as a duo, I figured I would see about getting a two-person team together once again for WC. So The Frybabies got on the start list for Female Duos.

Now I've heard all manner of descriptions of the Warrior Creek trail, fortunately almost exclusively positive, but some of them do make note of the tough steep climbs and wicked rocks. Also, I've seen some of the videos from previous races and although I realize helmet cam footage often distorts the trail reality, some sections on film do appear rather "ledgy" to my heights-fearing self. That, combined with my lack of fitness and strength, as well as the limited riding I've been doing lately due to a variety of excuses ranging from crappy weather to everyday life's excessive demands on my time, I've been more than a little nervous about this race.

Then Mother Nature decided to wreak additional havoc on my already stressed nerves by dumping mass quantities of rain, sleet and, yes, apparently SNOW on the trail today according to The Weather Service website, with bunches more rain forecast through the night and into the morning, leaving less than a day for the trail to (not) dry. Knowing that other trails in the Wilkesboro area - and I assume Warrior Creek as well - contain lots of that poorly draining North Carolina red clay, I have grave concerns about the trail conditions for race day coming up the day after tomorrow. Not the least of my worries is that I will be that slowpoke, timid, low level rider getting in everyone else's way. My duo teammate has volunteered to ride the first lap, so hopefully every rider that catches me by the time I head out will happen to do so on a stretch where there is room for me to safely and quickly move over and let them pass easily!

It's been a long time since I've been to a big race event, and the years in between have not been particularly kind to my lack of ambition and training. Coming back to the endurance race scene after all these years, 30 pounds heavier and now in my 50s, is scary and nerve-wracking. At the same time, it's something I feel I need to do, for myself.
At least now I have a bike in which I have total confidence - all I have to do is trust the Rip9 and my own abilities, kick all those self-doubts in the ass, get out there and prove to myself that I can still do this.